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Standard for the Operation of Swimming Pools and Spa ... - SA Health

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S O U T H A U S T R A L I A N H E A L T H C O M M I S S I O N C O D E<br />

S T A N D A R D<br />

F O R T H E<br />

<strong>Operation</strong> <strong>of</strong> <strong>Swimming</strong> <strong>Pools</strong> <strong>and</strong> <strong>Spa</strong> <strong>Pools</strong><br />

in South Australia<br />

SUPPLEMENT B<br />

HYDROTHERAPY POOLS<br />

( SOUTH AUSTRALIAN HEALTH COMMISSION )


March 1992<br />

SUPPLEMENT B ~ Hydro<strong>the</strong>rapy pools<br />

Prepared by:<br />

Environmental Surveillance Section,<br />

Environmental <strong>Health</strong> Branch<br />

Department <strong>of</strong> Human Services<br />

South Australian Government<br />

This guideline is one <strong>of</strong> a series <strong>of</strong> guidelines to<br />

assist Local Government in <strong>the</strong> administration <strong>of</strong> <strong>the</strong><br />

Public <strong>and</strong> Environmental <strong>Health</strong> Act <strong>and</strong> Regulations.<br />

Should you wish to comment on <strong>the</strong> in<strong>for</strong>mation<br />

in this guideline, your written comments are welcome<br />

<strong>and</strong> should be addressed to:<br />

Presiding Member,<br />

Public & Environmental <strong>Health</strong> Council<br />

PO Box 6, Rundle Mall, Adelaide 5000<br />

ISBN 0-7243-4086-6<br />

2


FOREWORD<br />

H Y D R O T H E R A P Y P O O L S<br />

Under <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Act, <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Council can initiate<br />

measures to promote public <strong>and</strong> environmental health st<strong>and</strong>ards <strong>and</strong> has <strong>the</strong> responsibility to keep <strong>the</strong> operation<br />

<strong>and</strong> administration <strong>of</strong> <strong>the</strong> Act under review.<br />

To assist local councils in <strong>the</strong> administration <strong>of</strong> <strong>the</strong> legislation <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Council has<br />

requested that “Supplement B” to <strong>the</strong> code “<strong>St<strong>and</strong>ard</strong> <strong>for</strong> <strong>the</strong> <strong>Operation</strong> <strong>of</strong> <strong>Swimming</strong> <strong>Pools</strong> <strong>and</strong> <strong>Spa</strong> <strong>Pools</strong> in<br />

South Australia” be prepared taking into account <strong>the</strong> provisions <strong>of</strong> Section 47(5) <strong>of</strong> <strong>the</strong> Act <strong>and</strong> Regulations 3<br />

<strong>and</strong> 6(1) as it relates to hydro<strong>the</strong>rapy pools. For <strong>the</strong> purpose <strong>of</strong> Regulation 3, a hydro<strong>the</strong>rapy pool is included<br />

within <strong>the</strong> definition <strong>of</strong> a swimming pool.<br />

“Supplement B” to <strong>the</strong> code “<strong>St<strong>and</strong>ard</strong> <strong>for</strong> <strong>the</strong> <strong>Operation</strong> <strong>of</strong> <strong>Swimming</strong> <strong>Pools</strong> <strong>and</strong> <strong>Spa</strong> <strong>Pools</strong> in South Australia”<br />

has been prepared to address <strong>the</strong> issue <strong>of</strong> water quality in relation to <strong>the</strong> operation <strong>of</strong> a hydro<strong>the</strong>rapy pool. It<br />

details measures necessary to ensure that water quality within a hydro<strong>the</strong>rapy pool is <strong>of</strong> a st<strong>and</strong>ard that does not<br />

prejudice <strong>the</strong> health or well being <strong>of</strong> hydro<strong>the</strong>rapy pool users.<br />

It describes in detail <strong>the</strong> disinfection <strong>of</strong> hydro<strong>the</strong>rapy pool water with reference to o<strong>the</strong>r important parameters<br />

such as pH, water clarity, total alkalinity <strong>and</strong> water turnover rates that need to be maintained in balance as part <strong>of</strong><br />

<strong>the</strong> total water treatment process.<br />

This supplement is aimed primarily <strong>for</strong> use by agencies responsible <strong>for</strong> <strong>the</strong> administration <strong>of</strong> <strong>the</strong> Public <strong>and</strong><br />

Environmental <strong>Health</strong> Regulations. However, it will also be very useful to <strong>the</strong> operators <strong>of</strong> hydro<strong>the</strong>rapy pools.<br />

Public <strong>and</strong> Environmental <strong>Health</strong> Regulation 3 details <strong>the</strong> facilities to which <strong>the</strong> provisions <strong>of</strong> this supplement<br />

apply <strong>and</strong> defines <strong>the</strong> circumstances <strong>of</strong> application.<br />

As provided <strong>for</strong> under Section 47(5) <strong>of</strong> <strong>the</strong> Act <strong>and</strong> Regulation 6(1)(a) , this supplement becomes part <strong>of</strong> <strong>the</strong><br />

prescribed code <strong>and</strong> non compliance with <strong>the</strong> provisions, except <strong>for</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool water turnover rate,<br />

that are applicable to <strong>the</strong> disinfection process including <strong>the</strong> maintenance <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool water so that it<br />

is chemically balanced, is deemed to be a breach <strong>of</strong> <strong>the</strong> legislation <strong>and</strong> subject to penalty as indicated in<br />

Regulation 6(3).<br />

3


CONTENTS<br />

FOREWORD 3<br />

INTRODUCTION 5<br />

DEFINITIONS 6<br />

MANAGEMENT 7<br />

WATER CLARITY 7<br />

PH & TOTAL ALKALINITY 7<br />

TURNOVER RATE & WATER REPLACEMENT 8<br />

TEMPERATURE & RELATIVE HUMIDITY 8<br />

DISINFECTION & TREATMENT OF WATER 8<br />

THE USE OF HYDROTHERAPY POOLS BY HIV/AIDS PATIENTS 9<br />

Australian National Council on Aids - Bulletin No. 6 9<br />

References 9<br />

TABLES 10<br />

ACKNOWLEDGMENTS 12<br />

REFERENCES 12<br />

4


INTRODUCTION<br />

H Y D R O T H E R A P Y P O O L S<br />

This code applies to <strong>the</strong> operation <strong>of</strong> hydro<strong>the</strong>rapy pools as defined by <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong><br />

Regulations, 1991.<br />

Hydro<strong>the</strong>rapy pools vary from o<strong>the</strong>r swimming pools in that <strong>the</strong>y have a higher operating temperature <strong>and</strong><br />

increased disinfectant level. The higher disinfectant level is required to compensate <strong>for</strong> <strong>the</strong> accelerated loss <strong>of</strong> <strong>the</strong><br />

disinfecting agent which dissipates due to <strong>the</strong><br />

increased water temperature.<br />

They are used <strong>for</strong> a range <strong>of</strong> <strong>the</strong>rapeutic purposes by persons recovering from injury or incapacity, by those who<br />

are immuno-compromised due to infection or have intellectual impairment <strong>and</strong> <strong>for</strong> fitness exercising. To<br />

minimize potential health risks to <strong>the</strong> users it is essential to ensure that <strong>the</strong> hydro<strong>the</strong>rapy pool is subject to proper<br />

management, operation <strong>and</strong> maintenance.<br />

The code sets out <strong>the</strong> approved methods <strong>of</strong> disinfection <strong>and</strong> treatment <strong>for</strong> hydro<strong>the</strong>rapy pool water. It has been<br />

prepared as a supplement to <strong>the</strong> South Australian <strong>Health</strong> Commission Code “<strong>St<strong>and</strong>ard</strong> <strong>for</strong> <strong>the</strong> <strong>Operation</strong> <strong>of</strong><br />

<strong>Swimming</strong> <strong>Pools</strong> <strong>and</strong> <strong>Spa</strong> <strong>Pools</strong> in South Australia” <strong>for</strong> use by local councils in <strong>the</strong> administration <strong>of</strong> <strong>the</strong><br />

legislation. It is also a useful guide <strong>for</strong> hydro<strong>the</strong>rapy pool owners <strong>and</strong> operators <strong>and</strong> will assist <strong>the</strong>m to comply<br />

with <strong>the</strong> provisions <strong>of</strong> <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Regulations, <strong>and</strong> to provide a facility that is <strong>of</strong> a high<br />

st<strong>and</strong>ard, safe, hygienic <strong>and</strong> enjoyable <strong>for</strong> <strong>the</strong> users.<br />

To ensure that <strong>the</strong> hydro<strong>the</strong>rapy pool is maintained in a clean, clear <strong>and</strong> safe condition this code recommends that<br />

<strong>the</strong> pool water turnover rate be at least once in every two hours or at least hourly where <strong>the</strong> use is heavy.<br />

This code should be read in conjunction with <strong>the</strong> South Australian <strong>Health</strong> Commission Code <strong>of</strong> Practice<br />

“<strong>St<strong>and</strong>ard</strong> <strong>for</strong> <strong>the</strong> Inspection <strong>and</strong> Maintenance <strong>of</strong> <strong>Swimming</strong> <strong>Pools</strong> <strong>and</strong> <strong>Spa</strong> <strong>Pools</strong> in South Australia”.<br />

All legislation, codes <strong>of</strong> practice, st<strong>and</strong>ards or guidelines referred to in this code include amendments made from<br />

time to time, unless o<strong>the</strong>rwise stated. The provisions <strong>of</strong> this code do not derogate from <strong>the</strong> need to comply with<br />

o<strong>the</strong>r laws <strong>of</strong> <strong>the</strong> State.<br />

5


DEFINITIONS<br />

chlorine hypochlorous acid/hypochlorite ion (irrespective <strong>of</strong> <strong>the</strong> mode <strong>of</strong> addition or <strong>for</strong>mation).<br />

combined chlorine chlorine that has combined with ammonia, ammonium compounds or organic matter<br />

containing nitrogen, to <strong>for</strong>m chloramines.<br />

disinfecting agent a compound or substance which, when applied as instructed to hydro<strong>the</strong>rapy pool<br />

water, kills harmful micro-organisms.<br />

free chlorine chlorine that has not combined, but is free to kill bacteria, algae <strong>and</strong> destroy organic<br />

pollutants introduced into <strong>the</strong> hydro<strong>the</strong>rapy pool water.<br />

hydro<strong>the</strong>rapy external application <strong>of</strong>, or partial immersion in water <strong>for</strong> <strong>the</strong>treatment <strong>of</strong> illness or<br />

injury or <strong>for</strong> fitness exercising.<br />

hydro<strong>the</strong>rapy pool a pool containing heated water <strong>and</strong> specially designed to meet <strong>the</strong> <strong>the</strong>rapeutic needs <strong>of</strong><br />

persons <strong>of</strong> any age with impairments due to illness, injury, disease, intellectual h<strong>and</strong>icap<br />

or congenital defects or <strong>for</strong> fitness exercising.<br />

knowledgeable person one who is able to control, manage <strong>and</strong> operate a hydro<strong>the</strong>rapy pool to ensure that <strong>the</strong><br />

pool water complies with <strong>the</strong> requirements <strong>of</strong> <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong><br />

Regulations.<br />

mg/L milligram per litre.<br />

occupier in relation to premises, means a person who has, or is entitled to, possession or control<br />

<strong>of</strong> <strong>the</strong> premises <strong>and</strong> includes a person who is in charge <strong>of</strong> <strong>the</strong> premises.<br />

operator <strong>the</strong> person who has control <strong>and</strong> management <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool, is<br />

knowledgeable in its operation <strong>and</strong> is sufficiently competent to ensure that <strong>the</strong> pool<br />

complies with <strong>the</strong> requirements <strong>of</strong> <strong>the</strong> regulations.<br />

owner in relation to premises, includes an occupier <strong>of</strong> <strong>the</strong> premises.<br />

pH scale (ranging from 0 to 14) that indicates <strong>the</strong> amount <strong>of</strong> acid or alkali present in <strong>the</strong><br />

water. Water with a pH <strong>of</strong> 7 is neutral.<br />

relative humidity <strong>the</strong> ratio <strong>of</strong> <strong>the</strong> pressure <strong>of</strong> water vapour in <strong>the</strong> air at any time to <strong>the</strong> pressure <strong>of</strong> water<br />

vapour that would saturate <strong>the</strong> air.<br />

superchlorination <strong>the</strong> addition <strong>of</strong> sufficient chlorine to hydro<strong>the</strong>rapy pool water toraise <strong>the</strong> level <strong>of</strong> free<br />

chlorine to at least 10mg/L <strong>for</strong> <strong>the</strong> destruction <strong>of</strong> combined chlorine (chloramines),<br />

algae <strong>and</strong> o<strong>the</strong>r impurities.<br />

swimming pool includes any waterslide, wave pool, hydro<strong>the</strong>rapy pool or o<strong>the</strong>r similar structure<br />

designed <strong>for</strong> human use, o<strong>the</strong>r than:<br />

(a) a spa pool<br />

or<br />

(b) a tidal pool or o<strong>the</strong>r similar structure where water flows in <strong>and</strong> out according to <strong>the</strong><br />

operation <strong>of</strong> natural <strong>for</strong>ces.<br />

total alkalinity a measure <strong>of</strong> <strong>the</strong> total amount <strong>of</strong> dissolved alkaline compounds in <strong>the</strong> hydro<strong>the</strong>rapy<br />

pool water.<br />

total chlorine <strong>the</strong> sum <strong>of</strong> combined chlorine <strong>and</strong> free chlorine.<br />

turnover rate <strong>the</strong> period <strong>of</strong> time taken to achieve complete exchange <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool water<br />

through <strong>the</strong> filter.<br />

UV+H2O2 ultraviolet light plus hydrogen peroxide disinfection system.<br />

m Ws/cm2 microwatt seconds per centimetre squared.<br />

6


MANAGEMENT<br />

H Y D R O T H E R A P Y P O O L S<br />

Where a hydro<strong>the</strong>rapy pool is available <strong>for</strong> use by <strong>the</strong> public <strong>the</strong> owner <strong>of</strong> <strong>the</strong> facility must ensure that <strong>the</strong><br />

hydro<strong>the</strong>rapy pool is under <strong>the</strong> control <strong>and</strong> management <strong>of</strong> a person who is knowledgeable <strong>and</strong> competent in <strong>the</strong><br />

operation <strong>and</strong> maintenance <strong>of</strong> hydro<strong>the</strong>rapy pool water. Whilst <strong>the</strong> facility is available <strong>for</strong> use by <strong>the</strong> public it is<br />

<strong>the</strong> responsibility <strong>of</strong> <strong>the</strong> owner <strong>and</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool operator to ensure that <strong>the</strong> hydro<strong>the</strong>rapy pool water<br />

quality is maintained in accordance with <strong>the</strong> requirements <strong>of</strong> <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Regulations.<br />

For <strong>the</strong> purpose <strong>of</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Regulation 8(1)(a) possession <strong>of</strong> a qualification approved by<br />

<strong>the</strong> South Australian <strong>Health</strong> Commission may constitute prima facie evidence <strong>of</strong> <strong>the</strong> knowledge <strong>and</strong> competence<br />

required <strong>of</strong> a person in charge <strong>of</strong> a hydro<strong>the</strong>rapy pool. The knowledge <strong>and</strong> competence <strong>of</strong> <strong>the</strong> operator may also<br />

be assessed by <strong>the</strong> st<strong>and</strong>ard <strong>of</strong> <strong>the</strong> water quality within <strong>the</strong> hydro<strong>the</strong>rapy pool as detailed below.<br />

Owners <strong>of</strong> hydro<strong>the</strong>rapy pools covered by <strong>the</strong> ambit <strong>of</strong> <strong>the</strong> regulations are responsible <strong>for</strong> ensuring that <strong>the</strong><br />

hydro<strong>the</strong>rapy pool is correctly operated. Failure to do so could result in legal proceedings being implemented <strong>for</strong><br />

non compliance.<br />

Where <strong>the</strong> operator <strong>of</strong> a hydro<strong>the</strong>rapy pool fails to maintain pool water quality in <strong>the</strong> manner prescribed <strong>the</strong><br />

authority may deem <strong>the</strong> operator not to be competent <strong>and</strong> require <strong>the</strong> owner to provide a person who is<br />

competent.<br />

It is recommended that <strong>the</strong>re should be sufficient trained staff available to provide constant supervision <strong>of</strong><br />

persons using <strong>the</strong> hydro<strong>the</strong>rapy pool <strong>and</strong> that speckle provisions be provided <strong>for</strong> persons with impairment or<br />

disability.<br />

WATER CLARITY<br />

Clarity <strong>of</strong> hydro<strong>the</strong>rapy pool water refers to <strong>the</strong> clearness or lack <strong>of</strong> cloudiness <strong>of</strong> <strong>the</strong> water <strong>and</strong> it may be<br />

regarded as <strong>the</strong> distance through <strong>the</strong> water at which an object can be seen. Under <strong>the</strong> Public <strong>and</strong> Environmental<br />

<strong>Health</strong> Regulations <strong>the</strong> clarity <strong>of</strong> hydro<strong>the</strong>rapy pool water must be such that a matt black disc, or a disc that<br />

contrasts with <strong>the</strong> colour <strong>of</strong> <strong>the</strong> bottom <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool, 150mm in diameter, is (or would be) clearly<br />

visible at <strong>the</strong> deepest part <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool. Removal <strong>of</strong> suspended <strong>and</strong> colloidal matter by filtration will<br />

assist in maintaining pool water clarity.<br />

The purpose <strong>of</strong> achieving clarity in hydro<strong>the</strong>rapy pool water is to:<br />

• confirm <strong>the</strong> absence <strong>of</strong> particles which may shield micro-organisms from direct contact with <strong>the</strong> disinfectant<br />

• enable persons to estimate depth, to see subsurface hazards easily <strong>and</strong> to detect submerged pool users<br />

• provide a safe, pleasant, attractive <strong>and</strong> appealing appearance to <strong>the</strong> water.<br />

The internal surfaces <strong>of</strong> hydro<strong>the</strong>rapy pools must provide high light reflection from <strong>the</strong> under water surfaces.<br />

This can help in detecting:<br />

• poor water quality<br />

• poor cleaning practices<br />

• ba<strong>the</strong>rs beneath <strong>the</strong> surface who may be in difficulties.<br />

pH & TOTAL ALKALINITY<br />

The pH <strong>of</strong> hydro<strong>the</strong>rapy pool water can affect <strong>the</strong> disinfection efficiency. It can also effect <strong>the</strong> pool surfaces,<br />

metal fixtures, pipework, pumps <strong>and</strong> ba<strong>the</strong>r com<strong>for</strong>t. Where <strong>the</strong> hydro<strong>the</strong>rapy pool water is disinfected with<br />

chlorine <strong>the</strong> pH factor is much more critical. There<strong>for</strong>e, <strong>the</strong> pH range must be limited, <strong>and</strong> its tendency to<br />

fluctuate must be controlled by ensuring a minimum level <strong>of</strong> total alkalinity. For <strong>the</strong> purpose <strong>of</strong> this code, total<br />

alkalinity is measured as calcium carbonate (CaCO 3 ).<br />

7


Hydro<strong>the</strong>rapy pool water disinfected with chlorine or ultraviolet light plus hydrogen peroxide requires a<br />

minimum total alkalinity level <strong>of</strong> 60mg/L. However, where gaseous chlorine is used <strong>the</strong> minimum total alkalinity<br />

level is 150mg/L. This ensures that <strong>the</strong> hydro<strong>the</strong>rapy pool water is chemically balanced <strong>and</strong> can be effectively<br />

disinfected.<br />

Total alkalinity levels greater than 200mg/L may result in scaling <strong>of</strong> fittings <strong>and</strong> surfaces, particularly with hard<br />

waters. Consequently hard waters may require treatment prior to being added to a hydro<strong>the</strong>rapy pool.<br />

Tables 1 to 3 detail <strong>the</strong> range <strong>of</strong> pH <strong>and</strong> total alkalinity values <strong>for</strong> disinfected hydro<strong>the</strong>rapy pool waters.<br />

TURNOVER RATE & WATER REPLACEMENT<br />

Hydro<strong>the</strong>rapy pools have a higher level <strong>of</strong> suspended matter than o<strong>the</strong>r swimming pools because <strong>of</strong> <strong>the</strong>ir high<br />

ba<strong>the</strong>r load, increased operating temperature <strong>and</strong> elevated organic contaminant loading. To lessen <strong>the</strong> impact <strong>of</strong><br />

this elevated level <strong>of</strong> suspended matter on disinfection efficacy it is recommended that <strong>the</strong> hydro<strong>the</strong>rapy pool<br />

water should be exchanged <strong>and</strong> passed through <strong>the</strong> filter at least once in every two hours. For heavily used<br />

hydro<strong>the</strong>rapy pools, such as those used <strong>for</strong> fitness exercising, <strong>the</strong> pool water turnover rate should be less than one<br />

hour. In those facilities where pool water turnover rate requirements vary, <strong>the</strong> hydro<strong>the</strong>rapy pool should be<br />

provided with a separate filter.<br />

For hydro<strong>the</strong>rapy pools with heavy ba<strong>the</strong>r loads it is recommended that approximately 25% <strong>of</strong> <strong>the</strong> pool water be<br />

replaced on a weekly basis. This should prevent <strong>the</strong> level <strong>of</strong> organic matter in <strong>the</strong> pool water reaching levels<br />

which may interfere with <strong>the</strong> disinfection process.<br />

TEMPERATURE & RELATIVE HUMIDITY<br />

Hydro<strong>the</strong>rapy pool water should not be heated to above 38oC. An ideal range is 28-35oC. Refer to tables 1 <strong>and</strong> 2.<br />

Any <strong>the</strong>rmostatic device controlling hydro<strong>the</strong>rapy pool water temperature should be capable <strong>of</strong> maintaining <strong>the</strong><br />

temperature to within +0.5oC <strong>of</strong> <strong>the</strong> set range. A high temperature alarm should be installed to in<strong>for</strong>m users that<br />

<strong>the</strong> water temperature exceeds 38oC. For user com<strong>for</strong>t <strong>the</strong> ambient air temperature <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool area should be no more than 10oC below<br />

<strong>the</strong> temperature <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool water.<br />

The relative humidity level <strong>of</strong> <strong>the</strong> air in <strong>the</strong> hydro<strong>the</strong>rapy pool area should be controlled to be within <strong>the</strong> range <strong>of</strong><br />

50% to 75%. The level can be maintained in this range by a fan boosted supply <strong>of</strong> fresh air <strong>and</strong> extraction <strong>of</strong><br />

humid air, or by air-conditioning with dehumidification. Care should be taken that no excessive draughts are<br />

created.<br />

DISINFECTION & TREATMENT OF WATER<br />

The following conditions must be achieved whenever a hydro<strong>the</strong>rapy pool is available <strong>for</strong> use:<br />

• <strong>the</strong> hydro<strong>the</strong>rapy pool water must be disinfected by chlorine or by an ultraviolet light plus hydrogen peroxide<br />

system so that <strong>the</strong> disinfection values set out in tables 1 <strong>and</strong> 3 are maintained<br />

• where chlorine is used <strong>the</strong> pH <strong>and</strong> total alkalinity values <strong>for</strong> <strong>the</strong> hydro<strong>the</strong>rapy pool water are to be maintained<br />

in accordance with tables 1 <strong>and</strong> 2<br />

• where an ultraviolet light <strong>and</strong> hydrogen peroxide system is used <strong>the</strong> pH <strong>and</strong> pool water flow rate must be<br />

maintained in accordance with <strong>the</strong> requirements set out in table 3<br />

8


H Y D R O T H E R A P Y P O O L S<br />

• <strong>the</strong> hydro<strong>the</strong>rapy pool must have a filtration system that provides a continuous circulation <strong>of</strong> <strong>the</strong> pool water<br />

through <strong>the</strong> filter. Ideally <strong>the</strong> hydro<strong>the</strong>rapy pool should have its own filtration system. Cartridge filters <strong>and</strong><br />

diatomaceous earth filters are not recommended<br />

• all water in <strong>the</strong> hydro<strong>the</strong>rapy pool must pass through <strong>the</strong> filter as <strong>of</strong>ten as necessary to ensure that <strong>the</strong> water is<br />

maintained in a clean <strong>and</strong> clear condition. It is recommended that this be at least once in every two hours <strong>and</strong><br />

<strong>for</strong> heavily used hydro<strong>the</strong>rapy pools <strong>the</strong> water should pass through <strong>the</strong> filter at least once in every hour<br />

• <strong>the</strong> hydro<strong>the</strong>rapy pool must be fitted with automatic dosing <strong>and</strong> monitoring equipment that continuously<br />

analyses <strong>and</strong> controls <strong>the</strong> pH <strong>and</strong> disinfectant levels in <strong>the</strong> hydro<strong>the</strong>rapy pool water within <strong>the</strong> range as<br />

indicated in tables 1 <strong>and</strong> 2<br />

• <strong>the</strong> hydro<strong>the</strong>rapy pool water clarity must be maintained in a clean, clear condition so that a 150 mm diameter<br />

matt black disc, or a 150 mm diameter disc that contrasts with <strong>the</strong> colour <strong>of</strong> <strong>the</strong> bottom <strong>of</strong> <strong>the</strong> hydro<strong>the</strong>rapy<br />

pool, is (or would be) clearly visible when viewed through <strong>the</strong> pool water at <strong>the</strong> deepest part <strong>of</strong> <strong>the</strong><br />

hydro<strong>the</strong>rapy pool.<br />

NOTE: Under <strong>the</strong> Public <strong>and</strong> Environmental <strong>Health</strong> Regulations stabilizers must not be<br />

used in any indoor swimming pool, which includes hydro<strong>the</strong>rapy pools since <strong>the</strong>y are<br />

defined in <strong>the</strong> Regulations as being swimming pools.<br />

It is recommended that stabilizers should not be used in outdoor hydro<strong>the</strong>rapy pools. The<br />

high operating temperature <strong>and</strong> organic loading found in outdoor pools provides an ideal<br />

environment <strong>for</strong> microbial growth. There<strong>for</strong>e a disinfectant which acts rapidly should be<br />

used in order to control this growth.<br />

THE USE OF HYDROTHERAPY POOLS BY HIV/AIDS PATIENTS<br />

Australian National Council on Aids - Bulletin No. 6<br />

Hydro<strong>the</strong>rapy pools containing warm water (28-35oC) are used by persons with a wide range <strong>of</strong> medical<br />

conditions <strong>for</strong> exercise as opposed to swimming.<br />

Pool water can become contaminated with micro-organisms arising ei<strong>the</strong>r from <strong>the</strong> user's bodies or from <strong>the</strong><br />

environment. Overuse <strong>and</strong> lack <strong>of</strong> proper disinfection may allow multiplication <strong>of</strong> certain bacteria <strong>and</strong> survival<br />

<strong>of</strong> certain viruses, posing a <strong>the</strong>oretical risk that subsequent users may become infected with such organisms.<br />

Hydro<strong>the</strong>rapy pools should <strong>the</strong>re<strong>for</strong>e be correctly maintained <strong>and</strong> disinfected, chlorine being <strong>the</strong> disinfectant <strong>of</strong><br />

choice at minimum free chlorine levels <strong>of</strong> 2.0mg/L. 1<br />

There are certain medical conditions in which hydro<strong>the</strong>rapy is contra-indicated, eg unstable cardiac conditions,<br />

acute infections <strong>and</strong> <strong>the</strong> presence <strong>of</strong> open or discharging wounds. The users <strong>and</strong> use <strong>of</strong> hydro<strong>the</strong>rapy pools should<br />

be subject to proper supervision.<br />

With regard to human immunodeficiency virus (HIV), survival or transmission <strong>of</strong> HIV in pool water has not been<br />

documented. HIV is susceptible to commonly used disinfectants especially those which are chlorine-based. 2<br />

There<strong>for</strong>e, if hydro<strong>the</strong>rapy pools are properly disinfected <strong>and</strong> <strong>the</strong>ir use supervised, <strong>the</strong>n use by patients with HIV<br />

infection poses no measurable risk to o<strong>the</strong>rs.<br />

References<br />

1. Australian <strong>St<strong>and</strong>ard</strong> 2610Part 1: Public <strong>Spa</strong> <strong>Pools</strong>, 1983, p10-11.<br />

2. SPIRE B et al, Inactivation <strong>of</strong> lymphadenopathy associated virus by chemical disinfectants,<br />

Lancet 1984; ii:899-901.<br />

9


TABLES<br />

TABLE 1: Hydro<strong>the</strong>rapy pool water disinfected with chlorine<br />

Pool water<br />

temperature<br />

* Disinfection values<br />

pH Total alkalinity<br />

mg/L<br />

Ideal Min - Max Min - Max Minimum free<br />

chlorine *,<br />

10<br />

Unstabilized pool water<br />

mg/L<br />

Maximum total<br />

chlorine *<br />

28 - 35 o C 7.2 - 7.6 60 - 200 ** 2.0 ***, Free chlorine<br />

as measured + 1.0<br />

** If gaseous chlorine is used <strong>the</strong> total alkalinity value must be in <strong>the</strong> range 150-200mg/L.<br />

*** For hydro<strong>the</strong>rapy pools operating at <strong>the</strong> upper temperature limit <strong>and</strong> under heavy ba<strong>the</strong>r loads it is recommended<br />

that <strong>the</strong> residual free unstabilized chlorine concentration be at least 4.0mg/L.<br />

NOTE: Under <strong>the</strong> legislation stabilizers are not to be used in indoor hydro<strong>the</strong>rapy pools<br />

<strong>and</strong> it is recommended that <strong>the</strong>y should not be used in outdoor hydro<strong>the</strong>rapy pools<br />

TABLE 2: Hydro<strong>the</strong>rapy pool water characteristics<br />

Characteristics<br />

pH<br />

Total alkalinity when<br />

disinfected with:<br />

- calcium hypochlorite<br />

- sodium hypochlorite<br />

- salt chlorinator<br />

- gaseous chlorine<br />

Temperature<br />

Range<br />

Min - Max<br />

7.2 - 7.6<br />

60 - 200 mg/L<br />

60 - 200 mg/L<br />

60 - 200 mg/L<br />

150 - 200 mg/L<br />

Ideal 28 o - 35 o C<br />

38 o C Max<br />

If pH is below 7.2 <strong>the</strong>n<br />

<strong>the</strong>re is a possibility <strong>of</strong>:<br />

- eye discom<strong>for</strong>t due to<br />

accelerated <strong>for</strong>mation<br />

<strong>of</strong> chloramines<br />

- rapid loss <strong>of</strong> chlorine<br />

- etching <strong>of</strong> exposed<br />

cement finished pools<br />

- corrosion <strong>of</strong> metals<br />

If total alkalinity is<br />

below 60,, <strong>the</strong>n <strong>the</strong>re is a<br />

possibility <strong>of</strong>:<br />

- pH fluctuation due to<br />

weak buffering effect<br />

- corrosion <strong>of</strong> metal<br />

If <strong>the</strong> temperature is too<br />

low, <strong>the</strong>n ba<strong>the</strong>rs may<br />

experience discom<strong>for</strong>t<br />

Comments<br />

If pH is above 7.6 <strong>the</strong>n <strong>the</strong><br />

possibility <strong>of</strong>:<br />

- reduction <strong>of</strong> chlorine<br />

disinfection efficiency<br />

- increased chlorine<br />

requirement<br />

- eye discom<strong>for</strong>t<br />

- drying <strong>of</strong> skin<br />

- cloudy water <strong>and</strong><br />

- scale <strong>for</strong>mation<br />

If total alkalinity is<br />

above 200 <strong>the</strong>n <strong>the</strong> possibility<br />

<strong>of</strong>:<br />

- high pH<br />

- cloudy water <strong>and</strong><br />

- scale <strong>for</strong>mation<br />

If <strong>the</strong> temperature is<br />

too high <strong>the</strong>n <strong>the</strong> possibility<br />

<strong>of</strong>:<br />

- increased use <strong>of</strong> chlorine<br />

- ba<strong>the</strong>r discom<strong>for</strong>t<br />

- increased evaporation <strong>and</strong><br />

- increased scaling potential


H Y D R O T H E R A P Y P O O L S<br />

TABLE 3: Operating criteria <strong>for</strong> hydro<strong>the</strong>rapy pool water disinfection using <strong>the</strong><br />

ultraviolet light plus hydrogen peroxide system<br />

* Disinfection values<br />

Ultraviolet light ≥ 30 000 mWs/cm 2 *<br />

Pool water flow rate ≤ 150 L/min<br />

Pool water turnover rate ≤ 2 hours **<br />

Hyrogen peroxide (H 2 O 2 ) level ≥ 40 mg/L *<br />

pH 7.2 - 7.6<br />

Total alkalinity 60 - 200 mg/L<br />

** Under <strong>the</strong> legislation <strong>the</strong> pool water turnover rate <strong>for</strong> swimming pools, which includes<br />

hydro<strong>the</strong>rapy pools, is to be at least once in every 6 hours. However, it is recommended<br />

that <strong>the</strong> pool water turnover rate <strong>for</strong> hydro<strong>the</strong>rapy pools be at least once in every two<br />

hours <strong>and</strong> <strong>for</strong> heavily used pools it should be less than one hour.<br />

NOTE: The ultraviolet light plus hydrogen peroxide system has been approved <strong>for</strong> use in<br />

indoor hydro<strong>the</strong>rapy pools having a capacity up to 500 000 litres.<br />

11


ACKNOWLEDGMENTS<br />

This code was developed by a working party comprising representatives from <strong>the</strong> following organisations:<br />

• Australian Institute <strong>of</strong> Environmental <strong>Health</strong> (S.A. Division)<br />

• Australian Institute <strong>of</strong> <strong>Swimming</strong> <strong>and</strong> Recreation Centre Management (S.A. Division)<br />

• Local Government Association <strong>of</strong> South Australia, Legal Services<br />

• <strong>Swimming</strong> Pool <strong>and</strong> <strong>Spa</strong> Association <strong>of</strong> Australia (S.A. Division)<br />

• South Australian <strong>Swimming</strong> Pool <strong>and</strong> <strong>Spa</strong> Industry<br />

• South Australian <strong>Health</strong> Commission, Environmental Surveillance Section.<br />

The Public <strong>and</strong> Environmental <strong>Health</strong> Council wishes to convey its sincere appreciation to <strong>the</strong> supporting<br />

organisations <strong>for</strong> making a representative available <strong>and</strong> to each member <strong>of</strong> <strong>the</strong> working party <strong>for</strong> <strong>the</strong>ir valued<br />

technical contribution.<br />

REFERENCES<br />

Public <strong>and</strong> Environmental <strong>Health</strong> Act, 1987 <strong>and</strong> Regulations, 1991.<br />

Australian <strong>St<strong>and</strong>ard</strong>s<br />

2610 <strong>Spa</strong> <strong>Pools</strong>.<br />

2610-1 Part 1: Public <strong>Spa</strong>s.<br />

2610-2 Part 2: Private <strong>Spa</strong>s.<br />

3633 Private <strong>Swimming</strong> <strong>Pools</strong> - Water Quality.<br />

LANG, Bryce, The Fundamentals <strong>of</strong> Private <strong>Swimming</strong> Pool <strong>Operation</strong> <strong>and</strong> Chemical Treatment.<br />

MITCHELL, P. Kirk, The Proper Management <strong>of</strong> Pool <strong>and</strong> <strong>Spa</strong> Water. Hydrotech Chemical Corporation.<br />

CLAYTON, Robert D., THOMAS, David G, Pr<strong>of</strong>essional Aquatic Management. Second Edition, Human<br />

Kinetics Books. Champaign, Illinois.<br />

GABRIELSEN, M. Alex<strong>and</strong>ir, <strong>Swimming</strong> <strong>Pools</strong> - A Guide To Their Planning, Design <strong>and</strong> <strong>Operation</strong>. Fourth<br />

Edition, Human Kinetics Publishers Inc. Champaign, Illinois.<br />

Australian Guidelines For Heated <strong>Spa</strong> <strong>Pools</strong>. National <strong>Health</strong> <strong>and</strong> Medical Research Council, Commonwealth<br />

<strong>of</strong> Australia, 1990.<br />

Australian Guidelines For Disinfecting Private <strong>Swimming</strong> <strong>Pools</strong>. National <strong>Health</strong> <strong>and</strong> Medical Research<br />

Council, Commonwealth <strong>of</strong> Australia, 1989.<br />

Public <strong>Swimming</strong> <strong>Pools</strong>. American Public <strong>Health</strong> Association.<br />

<strong>SA</strong>LVATO, Joseph A. Environmental Engineering <strong>and</strong> Sanitation.<br />

12

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